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Rectal Problems

Topic Overview

Rectal problems are common. Almost everyone will experience some rectal itching, pain, or bleeding at some time during his or her life. These problems are often minor and may go away on their own or with home treatment.

Rectal itching

Rectal itching (pruritus) is usually not a sign of a serious disease. At first, the skin of the anal area may appear red. Itching and scratching may make the skin become thickened and white. Common causes of rectal itching include:

Poor cleaning of the area after a bowel movement. Itching and discomfort may occur when pieces of stool become trapped in skin folds around the anus.

Medicines, especially medicines that cause diarrhea or constipation, such as antibiotics.

Cleaning of the anus with very hot water and strong soaps. The anal area is normally oily, and this barrier protects against the irritation of bowel movements. Repeated cleaning or showering will remove these oils and can lead to a cycle of itching and scratching that can be hard to stop.

The use of scented toilet paper, scented soap, or ointments (such as those that contain benzocaine).

A generalized dry skin condition that affects the entire body. This condition is more common in older adults. For more information, see the topic Dry Skin and Itching.

Hemorrhoids. Hemorrhoids are enlarged veins near the lower end of the rectum or outside the anus. For more information, see the topic Hemorrhoids.

Rectal bleeding

Many people have small amounts of rectal bleeding. Irritation of the rectum from diarrhea or constipation, a small hemorrhoid, or an anal fissure can cause a small amount of bright red blood on the surface of the stool or on the toilet paper. Hemorrhoids and anal fissures usually occur after straining during a bowel movement because of constipation. This type of bleeding can cause pain during a bowel movement and does not make the toilet water bloody. It is not serious if there is only a small amount of blood and the bleeding stops when the diarrhea or constipation stops. Home treatment is usually all that is needed.

Bleeding can occur anywhere in the digestive tract. The blood is digested as it moves through the digestive tract. The longer it takes the blood to move through the digestive tract, the less it will look like blood. Often blood that is caused by bleeding in the stomach will look black and tarry. A tarry stool has a black, shiny, sticky appearance and looks like tar on a road. Blood that has moved quickly through the digestive tract or that begins near the rectum may appear red or dark red.

Certain medicines and foods can affect the colour of the stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food colouring can turn the stool black.

Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.

A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.

Certain medicines and foods can affect the colour of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food colouring can turn the stool black.

If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Rectal itching is most often caused by dry or irritated skin in the rectal area. It can also be a sign of pinworms, especially in children.

Itching may be more serious if it occurs with a rash or if it does not improve with home treatment.

Home treatment for rectal itching includes things like:

Keeping the area clean and dry.

Washing the area with water several times a day and after bowel movements.

Sitting in a few inches of warm water in a bathtub.

Wearing loose-fitting cotton underwear.

Using a non-prescription hydrocortisone cream on the area.

Pain in adults and older children

Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.

Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.

Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.

Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

Passing out (losing consciousness).

Feeling very dizzy or light-headed, like you may pass out.

Feeling very weak or having trouble standing.

Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Symptoms of shock in a child may include:

Passing out (losing consciousness).

Being very sleepy or hard to wake up.

Not responding when being touched or talked to.

Breathing much faster than usual.

Acting confused. The child may not know where he or she is.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.

If you cannot reach your doctor or you don't have one, seek care today.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.

If you cannot reach your doctor or you don't have one, seek care in the next hour.

You do not need to call an ambulance unless:

You cannot travel safely either by driving yourself or by having someone else drive you.

You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Abdominal Pain, Age 11 and Younger

Abdominal Pain, Age 12 and Older

Home Treatment

Home treatment for rectal itching depends on the cause of the itching.

Treat causes of anal itching

Try these home treatment measures for the following causes of anal itching:

Poor hygiene. Clean the area gently with water-moistened cotton balls, a warm face cloth, or premoistened towelettes, such as Tucks or "baby wipes." A mild ointment, such as A+D Ointment or Desitin, can be applied lightly to help soothe the skin and protect it against further irritation.

Apply an ointment that contains hydrocortisone. Do not use other steroid creams on this sensitive area of your body, because skin damage can occur. Hydrocortisone cream should not be used for longer than 7 to 10 days without talking with your doctor. Do not use creams or ointments, such as Benadryl cream, that contain antihistamines. Note: Do not use the cream on children younger than age 2 unless your doctor tells you to. Do not use in the rectal or vaginal area in children younger than age 12 unless your doctor tells you to.

Excessive sweating. For anal itching caused by excessive sweating, avoid wearing tight-fitting underwear, and wear cotton, rather than synthetic, undergarments. You may use talcum powder to absorb moisture, but do not use cornstarch. Cornstarch may cause a skin infection. Before applying talcum powder, dry your rectal area with a hair dryer set on the low setting.

To control itching

To control itching, try the following:

Break the itch-scratch cycle, because further scratching leads to more itching. Take an oral antihistamine at night to help lessen your nighttime itching. Don't give antihistamines to your child unless you've checked with the doctor first.

Take a warm sitz bath 3 times each day and after each bowel movement. Following the bath, dry the anus carefully. You may wish to use a hair dryer set on low.

Avoid foods that can increase rectal itching, such as coffee, tea, cola, alcoholic beverages, chocolate, tomatoes, spicy foods, and excessive amounts of vitamin C, for a minimum of 2 weeks. Gradually add the items back to your diet, one item at a time, to help determine the cause of the itching.

Trim your fingernails short if you find yourself scratching irritated skin at night. Wear cotton gloves or socks on your hands at night to help stop the unconscious scratching that can occur while you sleep.

Control your stress. Being under stress and feeling anxious or worried can cause some people to experience skin itching. If you find you are scratching your anal area when you are anxious, try to take relaxation breaks throughout the day, especially before bedtime. For more information, see the topic Stress Management.

Symptoms to watch for during home treatment

The blood in your stool increases, or your stools become red, black, or tarry.

Swelling or a lump in or around your anus develops.

Symptoms become more severe or more frequent.

Prevention

To prevent rectal problems:

Use white, unscented toilet paper.

Do not use scented soaps. These can irritate the skin.

Practice good hygiene. Gently wipe the area with toilet paper after each bowel movement. If irritation starts, use water-soaked cotton balls to clean the area and then pat the area dry with dry cotton balls. Premoistened pads, such as Tucks or "baby wipes," may be less irritating.

Do not sit on the toilet for long periods of time.

Eat a high-fibre diet that includes plenty of fruits and vegetables and bran cereal every day.

Avoid foods that can cause rectal problems. Examples of such foods include:

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.